What are your go-to medical management options for high ileostomy output in patients with >100 cm of remaining small bowel?

First of all, you have to make sure that the patient's liquid intake is not composed of free water but an electrolyte solution at least 50% of the time.

• Metamucil at night
• Nana flakes in a milkshake at night

Medication stepwise:

• Maximize loperamide
• Add diphenoxylate
• Add a PPI to reduce acid secre...

Short gut can lead to hypergastrinemia; so check the gastrin level and give high-dose PPI or K-channel blocker if indicated. Somatostatin might help reduce secretion; Ceralyte could boost absorption.